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Wang B, Huang X, Liu G, Zheng T, Lin H, Qiao Y, Sun W. The sensitivity outcome index system for home care of elderly liver transplant patients was developed based on the Omaha problem classification system. BMC Med Inform Decis Mak 2024; 24:207. [PMID: 39054450 PMCID: PMC11270964 DOI: 10.1186/s12911-024-02617-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 07/22/2024] [Indexed: 07/27/2024] Open
Abstract
OBJECTIVE Based on the Omaha problem classification system, a sensitivity outcome index system for home nursing of elderly liver transplant patients was established. METHODS Through a comprehensive literature review and rigorous application of the Delphi method, a panel of 20 experts completed two rounds of effective letter consultation to obtain expert consensus opinions. The contents of indicators were determined based on this process, and the analytic hierarchy process was employed to confirm the weightage assigned to each indicator. Consequently, we established a sensitivity outcome index system for home care in elderly liver transplant patients. RESULTS The effective recovery rate of the questionnaire in two rounds of expert consultation was 100%, and the proportion of experts who gave opinions was 55% and 15%, respectively, indicating that the experts were highly active. The expert authority coefficients were calculated as 0.904 and 0.905, respectively, indicating a high degree of expert authority. In the second round, Kendall's coordination coefficients for primary, secondary, and tertiary indicators were determined to be 0.419, 0.418, and 0.394 (P < 0.001), indicating that expert opinions tended to be consistent. Finally, we established a comprehensive sensitivity outcome index system comprising 4 first-level indexes, 20 s-level indexes, and 72 third-level indexes specifically designed for elderly liver transplantation patients. CONCLUSION The sensitivity outcome index system of home nursing for elderly liver transplant patients can provide theoretical basis for nursing staff to build accurate individualized continuous nursing model.
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Affiliation(s)
- Bin Wang
- The Affiliated Hospital of Qingdao University, Qingdao City, 266071, Shandong Province, China
| | - Xia Huang
- The Affiliated Hospital of Qingdao University, Qingdao City, 266071, Shandong Province, China
| | - Guofang Liu
- The Affiliated Hospital of Qingdao University, Qingdao City, 266071, Shandong Province, China
| | - Taohua Zheng
- The Affiliated Hospital of Qingdao University, Qingdao City, 266071, Shandong Province, China
| | - Hui Lin
- The Affiliated Hospital of Qingdao University, Qingdao City, 266071, Shandong Province, China
| | - Yue Qiao
- The Affiliated Hospital of Qingdao University, Qingdao City, 266071, Shandong Province, China
| | - Wenjuan Sun
- The Affiliated Hospital of Qingdao University, Qingdao City, 266071, Shandong Province, China.
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Young AL, Rowe IA, Absolom K, Jones RL, Downing A, Meader N, Glaser A, Toogood GJ. The effect of Liver Transplantation on the quality of life of the recipient's main caregiver - a systematic review. Liver Int 2017; 37:794-801. [PMID: 27917588 DOI: 10.1111/liv.13333] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2016] [Accepted: 11/27/2016] [Indexed: 12/24/2022]
Abstract
Liver transplantation (LT) is a transformative, life-saving procedure with life-long sequale for patients and their caregivers. The impact of LT on the patient's main caregiver can be underestimated. We carried out a systematic review of the impact of LT on the Health-Related Quality of Life (HRQL) of LT patients' main caregivers. We searched 13 medical databases from 1996 to 2015. We included studies with HRQL data on caregivers of patients following LT then quality assessed and narratively synthesized the findings from these studies. Of 7076 initial hits, only five studies fell within the scope of this study. In general, they showed caregiver burden persisted in the early period following LT. One study showed improvements, however, the other four showed caregiver's levels of stress, anxiety and depression, remained similar or got worse post-LT and remained above that of the normal population. It was suggested that HRQL of the patient impacted on the caregiver and vice versa and may be linked to patient outcomes. No data were available investigating which groups were at particular risk of low HRQL following LT or if any interventions could improve this. The current information about LT caregivers' needs and factors that impact on their HRQL are not adequately defined. Large studies are needed to examine the effects of LT on the patients' family and caregivers to understand the importance of caregiver support to maximize outcomes of LT for the patient and their caregivers.
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Affiliation(s)
| | - Ian A Rowe
- Leeds liver unit, St James's University Hospital, Leeds, UK
| | - Kate Absolom
- Leeds Institute of Cancer and Pathology, University of Leeds, Leeds, UK
| | | | - Amy Downing
- Leeds Institute of Cancer and Pathology, University of Leeds, Leeds, UK
| | - Nick Meader
- Centre for Reviews and Dissemination, University of York, York, UK
| | - Adam Glaser
- Leeds Institute of Cancer and Pathology, University of Leeds, Leeds, UK
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Park J, Yoon S, Moon SS, Lee KH, Park J. The Effects of Occupational Stress, Work-Centrality, Self-Efficacy, and Job Satisfaction on Intent to Quit Among Long-Term Care Workers in Korea. Home Health Care Serv Q 2017; 36:96-111. [PMID: 28535108 DOI: 10.1080/01621424.2017.1333479] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
A large and growing population of elderly Koreans with chronic conditions necessitates an increase in long-term care. This study is aimed at investigating the effects of occupational stress, work-centrality, self-efficacy, and job satisfaction on intent to leave among long-term care workers in Korea. We tested the hypothesized structural equation model predicting the intention to quit among long-term care workers in Korea. Survey data were collected from 532 long-term care workers in Seoul, Korea. Results showed that occupational stress was positively associated with intention to leave the job. The study also identified several possible mediators (self-efficacy, work-centrality, job satisfaction) in the relationship between stress and intent to quit. Evidence-based stress management interventions are suggested to help the workers better cope with stressors. Mentoring programs should also be considered for new workers.
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Affiliation(s)
- Jeongkyu Park
- a Seoul Metropolitan Government , Seoul , Republic of Korea
| | - Seokwon Yoon
- b University of South Carolina , Columbia , South Carolina , United States
| | - Sung Seek Moon
- b University of South Carolina , Columbia , South Carolina , United States
| | - Kyoung Hag Lee
- c Wichita State University , Wichita , Kansas , United States
| | - Jueun Park
- b University of South Carolina , Columbia , South Carolina , United States
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Lerret SM, Weiss M, Stendahl G, Chapman S, Menendez J, Williams L, Nadler M, Neighbors K, Amsden K, Cao Y, Nugent M, Alonso E, Simpson P. Pediatric solid organ transplant recipients: transition to home and chronic illness care. Pediatr Transplant 2015; 19:118-29. [PMID: 25425201 PMCID: PMC4280334 DOI: 10.1111/petr.12397] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/27/2014] [Indexed: 01/20/2023]
Abstract
Pediatric SOT recipients are medically fragile and present with complex care issues requiring high-level management at home. Parents of hospitalized children have reported inadequate preparation for discharge, resulting in problems transitioning from hospital to home and independently self-managing their child's complex care needs. The aim of this study was to investigate factors associated with the transition from hospital to home and chronic illness care for parents of heart, kidney, liver, lung, or multivisceral recipients. Fifty-one parents from five pediatric transplant centers completed questionnaires on the day of hospital discharge and telephone interviews at three wk, three months, and six months following discharge from the hospital. Care coordination (p = 0.02) and quality of discharge teaching (p < 0.01) was significantly associated with parent readiness for discharge. Readiness for hospital discharge was subsequently significantly associated with post-discharge coping difficulty (p = 0.02) at three wk, adherence with medication administration (p = 0.03) at three months, and post-discharge coping difficulty (p = 0.04) and family management (p = 0.02) at six months post-discharge. The results underscore the important aspect of education and care coordination in preparing patients and families to successfully self-manage after hospital discharge. Assessing parental readiness for hospital discharge is another critical component for identifying risk of difficulties in managing post-discharge care.
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Affiliation(s)
- Stacee M Lerret
- Medical College of Wisconsin,Children’s Hospital of Wisconsin
| | | | | | | | | | | | | | | | - Katie Amsden
- Ann & Robert H. Lurie Children’s Hospital of Chicago
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Domínguez-Cabello E, Martín-Rodríguez A, Pérez-San-Gregorio M, Fernández-Jiménez E, Bernardos-Rodríguez A, Pérez-Bernal J. Relatives' Mental Health During the Liver Transplantation Process. Transplant Proc 2012; 44:2096-7. [DOI: 10.1016/j.transproceed.2012.07.083] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Lerret SM, Weiss ME. How ready are they? Parents of pediatric solid organ transplant recipients and the transition from hospital to home following transplant. Pediatr Transplant 2011; 15:606-16. [PMID: 21736682 DOI: 10.1111/j.1399-3046.2011.01536.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Poor discharge transition is evidence of a gap between evidence-based practices and current health care delivery. Pediatric SOT recipients are a vulnerable population at risk of complications during the discharge transition. The aim of this study was to investigate factors associated with the transition care from hospital to home. We studied the transition experience of parents of heart, liver, or kidney recipients to identify opportunities for improvement in discharge and post-discharge care processes and outcomes. Thirty-seven parents from three different pediatric transplant centers completed questionnaires on the day of hospital discharge and three wk following hospital discharge. Care coordination was associated with readiness for hospital discharge. Readiness for hospital discharge was subsequently associated with post-discharge coping difficulty, adherence difficulty with medical follow-up, and family impact. Identifying parents who are not ready to go home provides an opportunity to offer additional support services so parents can effectively manage their child's recovery and continuing care at home.
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Affiliation(s)
- Stacee M Lerret
- Children's Hospital of Wisconsin Marquette University, College of Nursing, Milwaukee, WI, USA.
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Weng LC, Huang HL, Wang YW, Chang CL, Tsai CH, Lee WC. Primary caregiver stress in caring for a living-related liver transplantation recipient during the postoperative stage. J Adv Nurs 2011; 67:1749-57. [PMID: 21443729 DOI: 10.1111/j.1365-2648.2011.05625.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
AIM The aim of this study was to explore the stress experienced by the primary family caregiver of the living-related liver transplantation patient during the postoperative stage. BACKGROUND Living-related liver transplantation is a treatment choice for end-stage liver disease patients who face a shortage of available donated livers. Research suggests that the caregiver of the liver transplant recipient experiences tremendous stress because a family member is on the waiting list. Nevertheless, there are limited studies that investigate the caregiver experience of stress during this surgery. METHOD This qualitative study used face-to-face semi-structured interviews to understand the subjective experiences of study participants. The study participants were drawn from a tertiary medical centre in northern Taiwan. During the data collection period (October 2007 to May 2008), 6 of the 12 caregivers agreed to participate in this study (N = 6), all of whom were female and, except for one participant, were the wives of the recipients. RESULTS Participant stress was caused by the gap between expectations and primary caregiving experiences. In particular, the five themes that were identified: (a) unstable sentiment towards liver transplantation; (b) entanglement of burden; (c) non-synchronized family interaction; (d) distance from the healthcare professional; and (e) concern about the protector role function. CONCLUSIONS The stress of primary caregivers of living-related liver transplantation is related to the gap between expectations and primary caregiving experiences. The immediate postoperative stage is a critical one for health professionals to provide intervention and management.
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Affiliation(s)
- Li-Chueh Weng
- School of Nursing, Chang Gung University, Taiwan, Taoyuan, Taiwan
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Hansen L, Sasaki A, Zucker B. End-Stage Liver Disease: Challenges and Practice Implications. Nurs Clin North Am 2010; 45:411-26. [DOI: 10.1016/j.cnur.2010.03.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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Bolden L, Wicks MN. Predictors of mental health, subjective burden, and rewards in family caregivers of patients with chronic liver disease. Arch Psychiatr Nurs 2010; 24:89-103. [PMID: 20303449 DOI: 10.1016/j.apnu.2009.04.010] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2008] [Revised: 03/17/2009] [Accepted: 04/28/2009] [Indexed: 02/07/2023]
Abstract
Patients with chronic liver disease (CLD) often experience severe symptoms that cause functional impairment and necessitate assistance from a family caregiver. Few studies investigate family caregivers of patients with CLD. This descriptive correlation study described demographic characteristics, depressive and anxiety symptom levels, and prevalence of hazardous drinking, rewards, and subjective burden and explicated predictors of subjective burden and mental health status for a convenience sample of 73 family caregivers of persons with CLD. Interventions are needed to offset decreased income reported by caregivers and to treat depressive symptoms; clinically significant levels were present, and clinical referrals were warranted in this study sample.
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Affiliation(s)
- Lois Bolden
- College of Nursing, University of Tennessee Health Science Center, Memphis, TN, USA.
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